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Impact of Neighborhood Disadvantage on Gastrointestinal Morbidity in Extremely Low Birthweight Infants

Samantha Shaffer1, Katie A Huff2, James Slaven3

  • 1Pediatrics, Indiana University School of Medicine, Indianapolis, USA.

Cureus
|July 29, 2025
PubMed

Insights

Infants with extremely low birth weight from disadvantaged backgrounds have a higher risk of necrotizing enterocolitis (NEC). This risk is amplified in Black infants, highlighting the need for targeted interventions to promote health equity in the neonatal intensive care unit (NICU).

Area of Science:

  • Neonatal research
  • Health equity
  • Social determinants of health

Background:

  • Necrotizing enterocolitis (NEC) and spontaneous intestinal perforation (SIP) are critical causes of illness and death in extremely low birth weight (ELBW) infants.
  • Social determinants of health (SDH) significantly influence neonatal outcomes in the neonatal intensive care unit (NICU).

Purpose of the Study:

  • To investigate the relationship between NEC, SIP, and SDH in ELBW infants.
  • To identify social vulnerability markers associated with NEC and SIP.

Main Methods:

  • Retrospective cohort study of infants born between 22 and 25 weeks gestation (2017-2023).
  • Area Deprivation Index (ADI) used as a measure of social vulnerability.
  • Analysis of 156 infants.

Main Results:

  • Infants diagnosed with NEC showed a significantly higher median ADI score, indicating greater socioeconomic disadvantage.
  • A notable finding was that no Black infants in the least disadvantaged areas developed NEC.
  • The study identified a correlation between higher ADI and NEC development.

Conclusions:

  • Infants from socioeconomically disadvantaged backgrounds face a higher likelihood of developing NEC.
  • This disparity is particularly pronounced among Black infants.
  • Findings suggest the potential for developing tailored feeding protocols to address health inequities in neonatal care.
Abstract

Keywords:
extremely low birthweight infantnecrotizing enterocolitisnicuprematuritysocial determinants of health

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